Hold your needles in women with recurrent pregnancy losses with or without hereditary thrombophilia: Meta-analysis and review of the literature - 16/03/21

Doi : 10.1016/j.jogoh.2020.101935

Stergios Intzes, Marianthi Symeonidou, Konstantinos Zagoridis, Maria Stamou, Athina Spanoudaki, Emmanouil Spanoudakis ^⁎
Democritus University of Thrace, Medical School, Department of Hematology, Greece

^⁎Corresponding author at: Democritus University of Thrace, Medical School, Alexandroupolis, Area of Dragana, PC 68100, Greece.Democritus University of ThraceMedical SchoolArea of DraganaAlexandroupolisPC 68100Greece

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Highlights

•	We extracted data from 12 RCTs and we analyze them according to presence or not of hereditary thrombophilia and according to quality of studies (Jadad score).
•	LMWH does not increase live birth rate in women with or without hereditary thrombophilia and RPL.
•	High quality studies (Jadad score) does not support the use of LMWH in women with RPL

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Abstract

Objectives

The use of antithrombotic prophylaxis in women with recurrent pregnancy losses (RPL) remains controversial.

Methods

We performed meta-analysis of randomized controlled trials (RCTs) comparing low molecular weight heparin (LMWH) versus No LMWH in women with or without hereditary thrombophilia and RPL. Twelve RCTs met our inclusion criteria and 2298 women were included in this meta-analysis. Our primary end point was live birth and odds ratio (OR) for live birth are reported.

Results

In women with thrombophilia the benefit of LMWH on live birth is not significant but heterogeneity of the studies is significant (OR, 2.09; 95 % CI, 0.58–7.57; p = 0.26; I² = 86 %, p = 0.0001). Considering women without thrombophilia there is no benefit of LMWH in OR of live birth and data from studies have low heterogeneity (OR, 1.25; 95 % CI, 0.88–1.78; p = 0 0.21; I² = 44 %, p = 0.07).